Protocol

REVVE: Protocolized Intervention for Biofilm-Driven Meibomian Gland Disease

REVVE is an acronym for Recognize, Exfoliate, Vaporize, Vibrate, and Express — the sequenced steps of a protocolized intervention designed to reduce biofilm burden, address inflammation, and restore meibomian gland expressibility. This page explains the scientific rationale, sequencing, and clinical logic of the REVVE protocol. It is intended for clinicians, scientific reviewers, and investors evaluating how Meibum Scientific operationalizes its disease model.

Design principleConsistency, sequencing, durability
Core aimReduce biofilm and inflammation; restore expressibility
Clinical postureIterative reassessment and interval optimization
Why protocolization matters

Structure improves repeatability

Dry eye and blepharitis are chronic inflammatory diseases with predictable progression. Episodic or non-standardized interventions often produce inconsistent outcomes because they fail to address disease drivers in a structured, repeatable manner.

The REVVE protocol was developed to introduce consistency, sequencing, and durability into the treatment of biofilm-driven meibomian gland disease.

Problem

Non-standardized treatment can leave inflammatory sources partially addressed, leading to variable response.

Approach

Protocolization standardizes sequence, reassessment, and interval planning to support durable control.

The REVVE treatment framework

Sequenced intervention with iterative reassessment

REVVE is a protocolized approach designed to eliminate biofilm, reduce inflammation, and restore meibomian gland expressibility. The protocol emphasizes sequence-dependent intervention and iterative reassessment based on clinical response.

Step 1

Lid Margin Debridement

The protocol begins with mechanical removal of lid margin biofilm and debris. This step reduces surface bacterial load, limits ongoing toxin release, and prepares the glandular system for deeper intervention.

Primary objective

Reduce surface biofilm burden and debris.

Clinical logic

Lower surface load and improve readiness for deeper steps.

Step 2

Intraglandular Biofilm Disruption

Following surface debridement, targeted intraglandular biofilm disruption is performed. This step addresses biofilm within the glandular structures themselves, where inflammation is sustained and conventional therapies have limited penetration.

Primary objective

Disrupt biofilm within glandular structures.

Clinical logic

Address deeper inflammatory sources that are not reachable by surface-only approaches.

Step 3

Vibrating Thermal Expression

Controlled thermal energy combined with vibration facilitates evacuation of diseased meibum, biofilm remnants, bacteria, and inflammatory byproducts. This step supports restoration of physiologic oil flow and improved gland expressibility.

Primary objective

Evacuate obstructive contents and support oil flow.

Clinical logic

Improve expressibility after inflammatory burden reduction.

Treatment cadence and maintenance

Repetition until stability, then interval extension

Treatments are typically repeated at defined intervals until consistent expression of clear, healthy oil is observed. Maintenance intervals are then extended based on clinical stability, supporting durable disease control rather than episodic symptom management.

Reassess

Evaluate expressibility, inflammatory features, and symptom trajectory at each visit.

Repeat

Continue protocol cycles at defined intervals until stability criteria are met.

Maintain

Extend intervals based on sustained stability while monitoring for recurrence.

Treatment cadence is individualized. Clinical judgment and patient-specific factors guide interval planning.

Implementation and Inquiry

For clinician and partner inquiries, Meibum Scientific can provide protocol context, education materials, and implementation guidance.

Contact

For clinician and partner inquiries.

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